What insurance policy changes affect code I70.92?

There are 6 tracked policy changes affecting code I70.92, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code I70.92?

Payers that have issued tracked updates for code I70.92 include: Aetna.

How do I get notified when code I70.92 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code I70.92. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code I70.92?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

I70.92 Insurance Policy Changes

ICD-10 I70.92 is officially defined as "Chronic total occlusion of artery of the extremities." code I70.92 is referenced in 6 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code I70.92 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 1, 2026Medium impact
Pulmonary Hypertension Treatments and Selected Indications of Prostanoids (CPB 0184, reviewed 2026-09-02)
Aetna considers epoprostenol (Flolan, Veletri, or generic epoprostenol injection), iloprost inhalation (Ventavis), treprostinil inhalation (Tyvaso), and treprostinil injection (Remodulin or generic treprostinil injection) medically necessary for pulmonary arterial hypertension (PAH) when the initial approval criteria are met, and for pulmonary hypertension associated with interstitial lung disease (PH-ILD) for Tyvaso only. Aetna considers sotatercept-csrk (Winrevair) medically necessary for PAH in members 18 years of age and older when PAH is confirmed by right heart catheterization and the drug is used as add-on therapy alongside medications from at least two of the listed PAH drug classes. Continuation of these therapies is considered medically necessary for members who receive them through a previously authorized pharmacy or medical benefit and who show disease stability or disease improvement.
Aetna · Identified Aug 14, 2026Medium impact
Near-Infrared Vascular Imaging and Near-Infrared Fluorescence Imaging (CPB 0846, reviewed 2025-12-04)
Aetna considers near-infrared vascular imaging and near-infrared fluorescence imaging experimental, investigational, or unproven for the indications listed in the policy. These include intra-operative fluorescence imaging of extra-hepatic bile ducts with indocyanine green for assessment of liver function, intra-parenchymal near-infrared spectroscopy for detection of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage, sentinel lymph node detection with indocyanine green in cutaneous melanoma and oral squamous cell carcinoma, and Cision InVision short-wave infrared imaging for pathological imaging. Other listed indications include diagnosis of peripheral artery disease, diagnosis of rheumatoid arthritis, sentinel lymph node mapping in endometrial cancer, transcutaneous NIR spectroscopy for monitoring kidney and liver allograft perfusion, and near-infrared vascular imaging systems for assessment of cutaneous wound and guiding vascular access.
Aetna · Identified Aug 14, 2026Medium impact
Pulmonary Hypertension Treatments and Selected Indications of Prostanoids (CPB 0184, reviewed 2025-09-08)
Aetna's commercial policy sets the criteria for epoprostenol (Flolan, Veletri), iloprost inhalation (Ventavis), treprostinil inhalation (Tyvaso) and treprostinil injection (Remodulin) for pulmonary arterial hypertension (PAH, WHO Group 1), with Tyvaso also covered for pulmonary hypertension associated with interstitial lung disease (PH-ILD, WHO Group 3) when criteria are met. Sotatercept-csrk (Winrevair) is covered for members 18 years of age and older with PAH when they meet its add-on criteria, and atrial septostomy and balloon pulmonary angioplasty are covered for refractory severe PAH with right heart failure. Aetna considers pulmonary artery hypertension drugs experimental for pulmonary hypertension secondary to asthma, chronic obstructive pulmonary disease, congestive heart failure, ischemic vascular disease or lung resection.
Aetna · Identified Aug 13, 2026Medium impact
Endovascular Arterial and Venous Stent Procedures (CPB 0785, reviewed 2026-06-05)
Under this Aetna policy, covered arterial stenting with FDA-approved stents includes primary or salvage therapy for popliteal artery aneurysm when the aneurysm is symptomatic or 2.0 cm or larger and the member has high peri-operative surgical risk, primary therapy for common iliac, external iliac and chronic mesenteric ischemia, salvage therapy for femoral, popliteal and tibial arteries after a sub-optimal balloon result, and renal artery stenting for atherosclerotic disease when listed criteria are met. Covered venous stenting includes the superior vena cava for superior vena cava syndrome, post radiation venous stenosis or congenital stenosis, ilio-caval venous occlusion, hemodialysis access graft or fistula stenosis or occlusion, May-Thurner syndrome and recurrent cephalic arch stenosis. Biodegradable stents, hybrid foot vein arterialization, primary stenting of tibial or infra-popliteal lesions, the DETOUR system for peripheral arterial disease and the LimFlow Stent Graft System for critical limb ischemia are listed as experimental, investigational or unproven, and certain peripheral arterial disease procedures are reviewed by EviCore by Evernorth under its own medical necessity criteria.
Aetna · Identified Aug 13, 2026Medium impact
Peripheral Atherectomy and Thrombectomy Devices (CPB 0295, reviewed 2026-04-16)
Aetna considers peripheral atherectomy of the renal artery, visceral artery, abdominal aorta, and brachiocephalic trunk and branches experimental, investigational, or unproven because its effectiveness has not been established. The same classification applies to the BYCROSS atherectomy device for peripheral arterial disease, intravascular shockwave lithotripsy for the listed peripheral arteries, celiac artery occlusion and renal artery stenosis, and isolated segmental pharmaco-mechanical thrombolysis (Trellis Peripheral Infusion System) for deep venous thrombosis, Paget-Schroetter syndrome, and other indications. Endovascular revascularization codes CPT 37220 through 37247 and 37254 through 37299 and drug-coated balloon catheter code HCPCS C2623 are covered when selection criteria are met, and medical necessity criteria for peripheral atherectomy are set in the EviCore Healthcare Peripheral Vascular Intervention Clinical Guidelines.
Aetna · Identified Aug 12, 2026Medium impact
Adoptive Immunotherapy and Cellular Therapy (CPB 0641, reviewed 2025-10-01)
Aetna's Clinical Policy Bulletin 0641 considers adoptive immunotherapy using tumor-infiltrating lymphocytes or IL-2-activated LAK cells, and a broad list of cellular therapies, experimental, investigational or unproven for the indications it names. Those indications include most cancers, Alzheimer disease, COVID-19, heart failure, ischemic heart disease, orthopedic and musculoskeletal disorders, and minimization of general immunosuppression in kidney transplant recipients. The policy names exceptions for lifileucel (Amtagvi) in melanoma and afamitresgene autoleucel (Tecelra) in synovial sarcoma, and it lists CAR T-cell therapy for solid tumors and virus-specific T-cell lymphocyte therapy for viral infections among the unproven uses.

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Pulmonary Hypertension Treatments and Selected Indications of Prostanoids (CPB 0184, reviewed 2026-09-02)

Near-Infrared Vascular Imaging and Near-Infrared Fluorescence Imaging (CPB 0846, reviewed 2025-12-04)

Pulmonary Hypertension Treatments and Selected Indications of Prostanoids (CPB 0184, reviewed 2025-09-08)

Endovascular Arterial and Venous Stent Procedures (CPB 0785, reviewed 2026-06-05)

Peripheral Atherectomy and Thrombectomy Devices (CPB 0295, reviewed 2026-04-16)

Adoptive Immunotherapy and Cellular Therapy (CPB 0641, reviewed 2025-10-01)

What insurance policy changes affect code I70.92?

Which payers have updated policy for code I70.92?

How do I get notified when code I70.92 policy changes?

Why do payers change policies for code I70.92?